The prevalence and multifactor analysis of thoracolumbar fasciitis in patients with osteoporotic vertebral compression fractures.

Abstract

Background context: Previous studies have reported that postoperative residual pain of osteoporotic vertebral compression fractures (OVCFs) may be associated with thoracolumbar fasciitis. However, to our knowledge, few reports have analyzed the prevalence and risk factors of thoracolumbar fasciitis in OVCFs.

Purpose: To investigate the prevalence and identify the risk factors of thoracolumbar fasciitis in OVCFs.

Study design/setting: A retrospective study.

Patient sample: We reviewed OVCFs patients from January 2018 to December 2022.

Outcome measures: Data on factors that could affect the occurrence of thoracolumbar fasciitis in OVCFs, such sex, age, type of trauma (apparent trauma and no evident trauma), body mass index (BMI), duration of pain, and comorbidities, were collected from the patients' medical records. Fat infiltration in the lumbar paraspinal muscles, fracture segments, number of vertebral fractures, paravertebral muscle area (PMA), psoas area (PA), relative PMA (rPMA) and relative PA (rPA) were radiologically examined.

Methods: Patients with OVCFs were divided into thoracolumbar fasciitis (TF) group and nonthoracolumbar fasciitis (NTF) group. Independent t-tests and chi-square tests were used in univariate analysis between 2 groups. To assess independent risk factors, multivariate logistic regression analysis was conducted on variables significant at p<.05 in univariate analysis.

Results: In this retrospective study, a total of 602 OVCFs patients were enrolled. Among 602 OVCFs patients, 286 were diagnosed with thoracolumbar fasciitis (TF group) and the rest into NTF group. In the univariate analysis, the related factors of thoracolumbar fasciitis in OVCFs included age (p=.001), rPMA (p<.001), fat infiltration in the lumbar paraspinal muscles (mild, moderate and severe infiltration) (p<.001), BMI (p=.002), types of trauma (no evident and apparent trauma) (p=.038) and hypertension (p=.04). In the multivariate analysis, the statistically significant risk factors of thoracolumbar fasciitis in OVCFs included age [odds ratio (OR)=1.036, p=.004], rPMA (OR=5.793, p<.001), severe paravertebral muscle fat infiltration (OR=2.759, p<.001), BMI (OR=1.081, p=.002) and apparent trauma (OR=1.643, p=.006).

Conclusion: The prevalence of thoracolumbar fasciitis in OVCFs is 47.51%. Independent risk factors identified for thoracolumbar fasciitis in OVCFs included advanced age, increased rPMA, severe paravertebral muscle fat infiltration, higher BMI and apparent trauma.